Source Madonna has spent her entire career tracking what the young are into.
The objective of any corporation is first to survive, then to thrive. A decade ago, tobacco companies had to shift into non-combustibles to survive as nicotine alternative products were threatening their markets. But they kept selling their cigarettes. Today, tobacco control advocates and many misinformed health leaders have confused the public about the relative safety of tobacco harm reduction products like e-cigarettes and nicotine pouches. Along with the WHO, they are advocating banning these new nicotine products or heavily taxing and restricting them. They have shifted their campaigns away from the fight against smoking. A recent article in the Financial Times notes how “cigfluencers” are gaining attention and how smoking is once again fashionable. This failure is due, in a large part, to the tobacco control activists. The tobacco industry has no issue with returning to the status quo.
Imagine an industry fighting to survive in the face of endless litigation attacks and that, on its knees, was suddenly given a lifeline. For a small price, governments built moats around their markets, ensuring no new players could enter and increase competition. This was the situation for the tobacco industry in the US following the 1998 Tobacco Master Settlement Agreement. Facing annihilation from a hungry litigation industry, the Agreement actually protected the industry. It wasn’t purely for charity – losing significant tax revenues was not on any government’s wish list. There was no reason for tobacco companies to change their strategies, balancing a gradual decline in tobacco sales in Western countries with increased opportunities in emerging markets.
But when non-combustible nicotine products like e-cigarettes, snus and nicotine pouches started to grow in popularity, countries like Sweden were rapidly moving toward smoke-free status, setting the benchmark for others to follow. As tobacco harm reduction strategies were effective in getting smokers to finally be able to quit, this started to threaten the long-term sustainability of the cigarette market. Suddenly the tobacco companies that were once sitting pretty in a protected market, had to diversify and innovate to survive.
Big Tobacco entered into the vaping, snus and nicotine pouch markets not because they wanted to, but because they had to. Tobacco products were losing market share at an increasing rate in Western countries in the 2010s as novel nicotine products like e-cigarettes emerged, with a significant number of smokers able to quit through vaping. Facing another endgame, this was both a threat and an opportunity for the tobacco industry.
As big tobacco companies bought smaller firms making alternative nicotine products, they developed innovations and invested in professional marketing campaigns to transition to the new opportunity, moving from surviving back to thriving. But as their products became popular, the tobacco control activists (having spent 50 years trying to eliminate Big Tobacco) took notice and decided to step in. They could not be allowed to once again thrive.
Tobacco and Nicotine Control: A $2 Billion Failure
Prohibition doesn’t work. It failed to curb alcohol consumption in the 1920s and 30s in America (and led to an increase in violent crime). It failed to be accepted when, as New York mayor, Michael Bloomberg tried to ban certain sugary drinks. Yet Bloomberg still thinks he can spend two billion dollars on tobacco control, having his flotilla of NGOs try to impose bans or restrictive regulations on tobacco and nicotine products. Because the same companies selling tobacco were also selling e-cigarettes and nicotine pouches, the products (with very different levels of human health risks) were treated identically.
As the main actor funding and implementing the WHO’s MPOWER strategy, Michael Bloomberg has co-opted the UN health body, leaving them no choice but to support the billionaire’s precautionary, prohibition strategy against tobacco harm reduction. It is one thing to be stubbornly wrong about prohibition (which has cost lives) but it is a far worse thing to be wrong about the effectiveness of harm reduction strategies from alternative nicotine products like e-cigarettes or nicotine pouches (which has cost many more lives).
There have been a large number of failures and deadly decisions made by Bloomberg’s $2 billion tobacco control lobby over the last decade, namely:
- Funding studies to focus on vaping health risks. To reject vaping as a smoking cessation strategy, researchers would have to demonstrate significant hazards from e-cigarettes. These studies, though, would not compare the small risks of vaping relative to smoking (even the European Commission asked its SCHEER risk assessment group to look only at the risks of vaping compared to not smoking). Nicotine is not a carcinogen and the risks from vaping are exponentially lower than that of smoking, but as the media amplify these Bloomberg-funded straw-clutching vaping studies, consumers become confused and decide to keep smoking.
- Promoting bans or restrictions on non-combustible nicotine products, flavour bans and higher taxes. All of these policies have herded consumers back into continuing to use much more harmful tobacco products. Black markets selling unregulated contraband have easily filled the void. In some countries, like Australia, the restrictive policies have led to gang violence, turf wars and lost tax revenue as up to 80% of nicotine products are sold on the black market. A recent study shows that almost half of Europe’s vape products are bought illicitly (but EU regulators are planning to emulate their Australian tobacco control colleagues).
- Focusing on stopping youth vaping. While there was an increase in youth vaping in the late 2010s, risk management measures, particularly in schools, led to a major decline in the number of young people using alternative nicotine products, with impressive declines over the last five years. But the activist “Protect the Children” campaign strategy has funnelled young people back into smoking. Banning vaping products or flavours just made tobacco an easier alternative for young people.
- Writing off harm reduction as a Big Tobacco marketing strategy. Harm reduction is an important human health risk management tool. From seatbelts to methadone to bicycle helmets, harm reduction measures are key to preventative health strategies. That the WHO-Bloomberg coalition tried to diminish the value of tobacco harm reduction strategies, like smokers quitting by switching over to e-cigarettes or nicotine pouches is an irresponsible dereliction in the duty to promote global public health. If consumers think that vaping will not really reduce their harm (and may be worse), then they will continue to smoke.
Preventing smokers from being able to quit smoking is one health policy failure. But perhaps the biggest mistake with the obsessive Bloomberg attacks on tobacco harm reduction strategies was to reduce their campaign budget spend on the real threat to human health: tobacco. This has allowed smoking to become fashionable again, prompting a new generation of smokers to pick up the habit.
The Renormalisation of Tobacco
For several decades, health campaigners succeeded in denormalising tobacco and smoking. But as the tobacco control movement followed Michael Bloomberg’s lead to focus their campaigns against novel nicotine products, they apparently dropped the ball on the important issue: smoking.
Risks are never considered in a vacuum but often consumers misunderstand the degrees of relative risk and potential harm. So seeing information on the hazards of vaping, many young people perceived a diminished threat from smoking. Cigarettes became cool again and celebrities were no longer risking their reputations being seen in public striking a pose with a cigarette. This was the subject of an article earlier this month in the Financial Times on the recent rise of the “cigfluencer”.
The title of the article says it all: “Smoking is back in fashion. Why?” Moving from near extinction in the arts world, it is no longer taboo for celebrities to be seen smoking in movies, on TV, at events and in public spaces. The author, Jude Jones, notes that in a world of wellness obsession, smoking has become a small act of rebellion in the “little-treat culture”. The number of photos in the Financial Times of celebrities and influencers posing with cigarettes was quite astonishing and does a good job raising the question: How did this happen?
In the world of health risk management, people need clear, consistent messages. For decades the public were told smoking was the single worst thing they could do to themselves. Now they hear that vaping or nicotine pouches are as bad or maybe worse than smoking (and tobacco has been around longer). Others see the shifting claims made by health activists and lose trust in their message. So not only has their confusing messages about tobacco harm reduction kept people smoking, their failure to communicate a clear message of risk has opened tobacco up to a new generation.
This is Michael Bloomberg’s $2 billion dollar failure, and while I, for one, don’t feel sorry for him, I recognise the enormous amount of work his demise has left for risk communicators to correct. It will take another generation.
It is ironic that in 2014 when e-cigarettes were emerging onto the market as a viable smoking cessation strategy, the WHO’s Framework Convention on Tobacco Control was compelled to reject them for the main reason that supporting e-cigarettes would overturn decades of success in denormalising smoking. After a decade of villainising tobacco harm reduction, the WHO now bears the responsibility for renormalising the tobacco industry.
A Message from Big Tobacco
I have been asked to convey a message from representatives in the tobacco industry to the directors of the WHO tobacco control programme, the health ministers in WHO member states who have uncritically implemented UN diktats (especially the European Commissioner for Health, Olivér Várhelyi), as well as Michael Bloomberg and all of the anti-nicotine activists aligned with and funded by him.
It reads as follows:
“Following your tireless work to confuse the public about the safety of tobacco harm reduction products, your obsession with campaigning against non-combustible nicotine products while seemingly dropping the ball on the campaign to vilify smoking, and given your efforts to ban or heavily restrict nicotine pouches and e-cigarettes, remove flavours or impose high levels of tax on these products relative to tobacco, we would like to express our deep-felt appreciation when we say:
THANK YOU !!!
Your relentless campaigns and uncompromising extremism have not only allowed our tobacco industry to survive, but your outright rejection of tobacco harm reduction strategies have promoted smoking, allowing our industry to continue marketing cigarettes and thriving (for a long time to come).”
